ACCOUNT OPENING FORM FOR INDIVIDUALS …

1 Bank of Baroda ACCOUNT OPENING form FOR INDIVIDUALS F. Branch: _____ Date: D D M M Y Y Y Y ACCOUNT No. Branch ALPHA Scheme Code ---------------------------------------- ---------------------------------------- ---------------------------------------- ------------- I/We request you to open my/our deposit ACCOUNT with your branch/bank as under: (Tick ( ) relevant type of ACCOUNT ) Type of ACCOUNT Scheme Name Type of ACCOUNT Scheme Name Savings Bank A/c Term Deposit A/c Current A/c Other A/c FULL NAME, in CAPITAL Letters (In the order of first, middle and last name, leaving a space between words)

2 M/F 1 2 3 Date of Birth (dd/mm/yyyy) PAN (if not available, please attach form 60/61) Customer ID(if any existing) 1 2 3 Occupation * Status ** Annual Income (in Rs.)

3 Relationship with 1st applicant Nationality Father's / Husband's Name 1 2 3 * Please choose from the following: Salaried Self Employed Professional Politician Housewife Student Defence Staff Retired Stock Broker Agriculture Antique Dealer Arms Dealer Business Others ** Please choose from the following (If Staff / Ex-Staff, mention Number): Minor Sr Citizen Staff (EC No. ) Ex-Staff (EC No. ) Pensioner NRI Other /General Relationship with minor ( tick one) Name of the Guardian (In case of Minor): (Attach Proof for minor s DOB) F & NG M & NG Legal* De facto Others * In case of legal guardian (guardian appointed by Court), enclose copy of the court order.

4 Name and address of Employer First Applicant 2nd Applicant 3rd Applicant Operating Instructions (Please mark in appropriate box): Self Either or Survivor Former or Survivor Jointly Any one or Survivor/s Others (Pl. Specify) Facilities required (Please mark in appropriate box/es): Cheque Book Statement of ACCOUNT through Issued Cheque Series to _____ Date of Issue: Pass book Post E mail Delivery at branch Statement Frequency: Monthly Quarterly * Internet Banking Baroda Connect Debit cum ATM Card * BOB Card (* Please fill up separate application for Internet Banking Baroda Connect and/ or BOB Card).

5 Please issue Debit cum ATM card in the name of the first / all applicants (in case of two joint a/c holders with operations as E or S / Any one or S): Name to appear on Debit cum ATM Card In CAPITAL LETTER (not to exceed 20 Characters) First applicant Second Applicant Third Applicant Residential address First Applicant 2nd Applicant 3rd Applicant Flat Name Street/ Road & Area/ Locality City and District State and Country Pin Code Tel No.

6 , Fax No. Mobile Email Bank of Baroda Communication Address (If different from Residential Address) First Applicant 2nd Applicant 3rd Applicant Flat Name Street/ Road & Area/ Locality City and District State and Country Pin Code Tel No., Fax No. Mobile Permanent Address / In case of NRE, local address in India Flat Name Street / Road & Area / Locality City and District State and Country Pin Code Tel No., OTHER INFORMATION: ( tick one) Education : Monthly Income (Rs.}: Expected Annual Turnover in the A/C: Rs.)

7 _____ If salaried, employed with: ( tick one) Proprietorship Public Ltd. MNC Partnership Public Sector Pvt. Ltd. Government Others (Pl. Specify) If Professional: ( tick one) Doctor Architect CA / CS IT Consultant Engineer Lawyer Others (pl. Specify) If Business: ( tick one) Manufacturing Real Estate Antique Service Provider Trader Arms Dealer Agriculture Stock Broker Others (Pl. Specify DECLARATION (Please mark in appropriate boxes): [ ] I / we declare that I / we do not enjoy any credit facilities with other bank/s. [ ] I / we declare that I / we have following deposit accounts and /or credit facilities with your / other banks branches: Bank & Branch Place of Bank / Branch Type of ACCOUNT / Facility Amount ACCOUNT No.)

8 TERMS & CONDITIONS & DECLARATION (Please mark in appropriate boxes): I/We have read, understood and agree to abide by the Bank s rules relating to the conduct of the above accounts / services/ products /Fee & charges which are displayed on the website / contained in the brochures of the Bank from time to time. [ ] I/We wish to be informed about the various features/ products and promotional offers made by the Bank from time to time. [ ] Please do not call/ contact me/us for various features/ products and promotional offers made by the Bank from time to time.

9 Please issue Multi-city / Normal cheque book and recover charges from my/our ACCOUNT as per norms of the bank (Give Option) ACCOUNT will be operated and balance along with interest payable as per operational instructions given above. I shall represent the said minor in all future transactions of any description in the above ACCOUNT until the said minor attains majority. I will indemnify the Bank against the claim of the above minor of any withdrawal/transactions made by me in his/her ACCOUNT . I / We understand that in the event of the death of the depositor(s), premature termination of term deposit would be allowed without any penal charges to the claimant(s) after following the due procedure.

10 I / We also agree to maintain the minimum / quarterly average balance which the Bank may prescribe as the minimum / quarterly average balance to be maintained to avail the facilities and agree to pay the charges if minimum / quarterly average balance is not maintained and any other charges stipulated by the Bank. I/We understand that any change in this respect will be notified by the Bank on its website and also will be displayed on the notice board of the branches one month in advance.